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Title: Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
Authors: Diáz-López, Andrés
Becerra-Tomás, Nerea
Ruiz, Verónica
Toledo, Estefania
Babio, Nancy
Corella, Dolores
Fitó, Montse
Romaguera, Dora
Vioque, Jesús
Alonso-Gómez, Ángel M.
Wärnberg, Julia
Martínez, J. Alfredo
Serra Majem, Luis 
Estruch, Ramon
Tinahones, Francisco J.
Lapetra, José
Pintó, Xavier
Tur, Josep A.
López-Miranda, José
Cano Ibañez, Naomi
Delgado-Rodríguez, Miguel
Matiá-Martín, Pilar
Daimiel, Lidia
De Paz, Jose Antonio
Vidal, Josep
Vázquez, Clotilde
Ruiz-Canela, Miguel
Bulló, Mònica
Sorlí, José V.
Goday, Albert
Fiol, Miquel
Garciá-De-La-Hera, Manoli
Tojal Sierra, Lucas
Pérez-Farinós, Napoleón
Zulet, Maria Ángeles
Sánchez Villegas, Almudena 
Sacanella, Emilio
Fernández-Garciá, José Carlos
Santos-Lozano, José Manuel
Gimenez-Gracia, Miquel
Del Mar Bibiloni, Maria
Diez-Espino, Javier
Ortega-Azorin, Carolina
Castañer, Olga
Morey, Marga
Torres-Collado, Laura
Sorto Sanchez, Carolina
Munõz, Miguel Ángel
Ros, Emilio
Martinez-Gonzalez, Miguel A.
Salas-Salvadó, Jordi
UNESCO Clasification: 32 Ciencias médicas
3206 Ciencias de la nutrición
Keywords: Dietary Intervention
Glomerular Filtration Rate
Kidney Function
Mediterranean Diet
Predimed-Plus, et al
Issue Date: 2021
Journal: American Journal of Nephrology 
Abstract: Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled "PREvención con DIeta MEDiterránea-Plus"(PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55-75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (EGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired EGFR (<60 mL/min/1.73 m2< >) and micro-to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m2< >) to mildly impaired GFR (60 to <90 mL/min/1.73 m2< >) or micro-to macroalbuminuria. Results: After 1 year, EGFR declined by 0.66 and 1.25 mL/min/1.73 m<>2< > in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2< >; 95% CI: 0.15-1.02). There were no between-group differences in mean UACR or micro-to macroalbuminuria changes. Moderately/severely impaired EGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44-0.82) and 92% higher (HR 1.92; 1.35-2.73), respectively, in the intervention group. Conclusions: The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.
ISSN: 0250-8095
DOI: 10.1159/000513664
Source: American Journal of Nephrology [ISSN 0250-8095], (Febrero 2021)
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